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Power is Confusing: Boundary Challenges for Mental Health Supervisors

Writer's picture: Kathryn KraseKathryn Krase

Professionals take on particular “roles” in the capacity of their work. Mental health professionals, for instance, might serve in roles as “therapist”, “counselor”, “advisor”, “advocate” and “coach”, among others. When a mental health professional serves as a “supervisor” their role might also include “mentor”, “authoritarian”, among others.  The definition and expectation of each role provides a boundary for that role. When the multiple roles of a professional overlap or challenge each other we consider these boundaries concerns. Boundary concerns for supervisors are particularly challenging because of the power dynamics; supervisors have considerable power over their supervisees.  When there are boundaries concerns the professional needs to carefully consider the implications, and make a decision that appropriately prioritizes certain roles.


Challenges to the Boundaries of Supervisors: Dual/Multiple Relationships


When a supervisor has a relationship with their client or supervisee outside the context of the professional services they are providing to that person we call that a “dual relationship” or “multiple relationship”.  For instance, a supervisor might shop at a store where a client works, or have children who go to the same school as a supervisee. Most commonly, supervisors might have a friendship outside of work with their supervisee. While dual/multiple relationships, especially with supervisees, might be very common they always bring about ethical risks related to boundaries.


When a professional has a dual relationship with a supervisee, there is a chance that the relationship outside their supervisor/supervisee role will impact the supervisor’s response to their professional duty. The risk largely comes from the power the supervisor has over their supervisee.  Those feelings that a supervisor might have related to that additional role with the supervisee are not focused on the goals of the supervisory relationship. As a result, the thoughts and feelings associated with the non-supervisory role might influence the decisions that the professional makes in their supervisory role. 


  • The supervisor might provide more attention to a supervisee they have a dual relationship with, than what they would give to other supervisees. That’s not fair to supervisees who don’t have a dual relationship with the supervisor. 

  • The supervisor might miss important factors in their evaluation and support of the supervisee they have a dual relationship with because they make assumptions about what they know, or need to know, about the supervisee. This isn’t fair to the supervisee in the dual relationship with the professional. And,

  • The supervisee in the dual relationship with their supervisor might not be as willing to share compromising details that are necessary for the supervisor to provide them with the best level of support, because they are concerned this information might change the way the supervisor thinks about them personally. This limitation in particular puts the supervisee and supervisor at great risk from the dual relationship.


For these reasons, and many more, supervisors should be very careful and deliberate when entering into dual relationships with supervisees. 


This is especially true about romantic and sexual relationships with supervisees. Supervisors who have romantic and/or sexual relationships with supervisees are risking legal and ethical liability. Concerns for exploitation of the supervisee are paramount. While there is rarely an express prohibition against these relationships, there is inherent concern for lack of autonomy of the supervisee, even if they express consent. The supervisor takes on great risk when entering into such a relationship.


Dual relationships between supervisors and supervisees are not explicitly prohibited. There are certain roles, settings, and locations where such dual relationships are more likely to occur. No matter their frequency, dual relationships between supervisors and supervisees should always be ethically evaluated, to insulate both from the inherent risks of these relationships. 


Boundaries Case Examples: Using the Ethical Principles Framework


Let’s examine a few case examples of boundaries challenges for supervisees, and apply the ethical principles framework (Beneficence, Nonmaleficence, Autonomy and Justice) discussed in this blog to help make a determination of the best course of action.


Talking about private/personal matters


It is very common for coworkers to talk about private and personal matters with each other. For instance, you might share your vacation plans, or show pictures when you return. You might confide in a coworker when you’re experiencing a challenging family situation, or share the excitement of a special achievement. When your coworker is your “equal” the risks of this connection are minimal. When there is a power imbalance, there are more considerable risks. As a supervisor, you should be able to explain how these communications with your supervisees are ethically appropriate.


When telling your supervisees about your vacation plans, whose benefit is this communication for? It might bring you joy, and thus a benefit for you. What benefit is this to your supervisee? Is this communication happening during their supervision time? If so, they are actually being harmed by not focusing on them, triggering concerns for nonmaleficence. Does the supervisee actually have the choice to say “I’m not interested in this…”? Not really. So, their autonomy is limited. And when it comes to justice, supervisors should be very thoughtful about perpetuating class differences through these communications. It’s not illegal or unethical to share your vacation plans with your supervisee, but an ethical supervisor would be able to explain how they considered the four ethical principles, prioritizing their supervisee.

 

Attending a Supervisee’s Social Event


A colleague’s social event might be the highlight of a workplace’s calendar. Everyone at the office might be invited. What should a supervisor consider before attending a supervisee’s social event? The four ethical principles, of course!


Whose beneficence is prioritized when a supervisor attends this event? The supervisee’s beneficence might be supported. The supervisee might be excited to share a special occasion with the supervisor. They might be honored the supervisor took the time to be there, for instance. The supervisor’s beneficence might be supported, since they will likely benefit from free food, drink and fun. 


Is there really a risk of harm attending a supervisee’s social event? You bet there is. The supervisor and supervisee will learn things about each other just by seeing how they interact in that non-work space. This occasion might change the way they interpret each other back in the office. What if one, or the other, or both, drink excessively, and/or say things that they wouldn’t feel comfortable saying in the office? These are risks. Some risks are always present, but they might be manageable. This is where autonomy comes into play.


If the supervisee invited the supervisor, and therefore autonomy and choice of the supervisee might seem apparent. But, is the supervisor sure the supervisee wants them there? Was the supervisor invited because everyone else was being invited, and the supervisee didn’t want the supervisor to feel excluded? Choice might not be so apparent. The supervisor, therefore, should be the one considering the risks and benefits, and try to honestly communicate concerns with the supervisee whenever possible.


Justice and fairness should also be considered. If the supervisor has engaged in social activities with some supervisees, but not others, this is problematic. A supervisor should be prepared to explain how a choice to attend, or not attend, a supervisee’s social event is fair and just. 


All professional roles present ethical challenges that need to be carefully evaluated. The role of supervisor has additional responsibilities due to the unique power imbalance with supervisees. Using the four ethical principles to evaluate ethical challenges will help the supervisor feel confident in the decisions they make.


For more information, resources and training opportunities check out www.makingthetoughcall.info and www.kraseconsulting.com



References:

Barnett, J. E., & Molzon, C. H. (2014). Clinical supervision of psychotherapy: Essential ethics issues for supervisors and supervisees. Journal of Clinical Psychology, 70(11), 1051-1061.

Borders, L. D., & Brown, L. L. (2022). The new handbook of counseling supervision. Routledge.

Corey, G., Haynes, R. H., Moulton, P., & Muratori, M. (2020). Clinical supervision in the helping professions: A practical guide. John Wiley & Sons.

Hutman, H., Ellis, M. V., Moore, J. A., Roberson, K. L., McNamara, M. L., Peterson, L. P., ... & Zhou, S. (2023). Supervisees’ perspectives of inadequate, harmful, and exceptional clinical supervision: Are we listening?. The Counseling Psychologist, 51(5), 719-755.

Pratt, K. J., & Lamson, A. L. (2012). Supervision in behavioral health: Implications for students, interns, and new professionals. The journal of behavioral health services & research, 39, 285-294.

Reamer, F. G. (2020). Boundary issues and dual relationships in the human services. In Boundary Issues and Dual Relationships in the Human Services. Columbia University Press.

Thomas, J. T. (2010). The ethics of supervision and consultation. Washington, DC: American Psychological Association.


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